<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">
        
        <div class="layui-form-item">
            <label class="layui-form-label">uid</label>
            <div class="layui-input-block">
                <input type="text" name="uid" class="layui-input"  placeholder="请输入uid" value="0">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">真实姓名</label>
            <div class="layui-input-block">
                <input type="text" name="real_name" class="layui-input"  placeholder="请输入真实姓名" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">province</label>
            <div class="layui-input-block">
                <input type="text" name="province" class="layui-input"  placeholder="请输入province" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">city</label>
            <div class="layui-input-block">
                <input type="text" name="city" class="layui-input"  placeholder="请输入city" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">area</label>
            <div class="layui-input-block">
                <input type="text" name="area" class="layui-input"  placeholder="请输入area" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">申请原因</label>
            <div class="layui-input-block">
                <input type="text" name="reason" class="layui-input"  placeholder="请输入申请原因" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">状态（0待审核，1通过，2拒绝）</label>
            <div class="layui-input-block">
                <input type="text" name="status" class="layui-input"  placeholder="请输入状态（0待审核，1通过，2拒绝）" value="0">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">拒绝原因</label>
            <div class="layui-input-block">
                <input type="text" name="reject_reason" class="layui-input"  placeholder="请输入拒绝原因" value="">
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>

    </form>
</div>